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Comparison of short‐ and long‐term complications and survival following jejunojejunostomy, jejunoileostomy and jejunocaecostomy in 112 horses: 2005–2010
Author(s) -
Stewart S.,
Southwood L. L.,
Aceto H. W.
Publication year - 2014
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.12143
Subject(s) - medicine , confidence interval , medical record , surgery , horse , anastomosis , biology , paleontology
Summary Reasons for performing the study There is disagreement among surgeons over whether jejunoileostomy ( JI ) or jejunocaecostomy ( JC ) is the better method of anastomosis following proximal ileal resection. Objective To compare short‐ and long‐term complications and outcome in horses undergoing jejunojejunostomy ( JJ ), JI and JC and to test the hypotheses that a higher proportion of horses undergoing JI would have short‐term complications and mortality compared with horses undergoing JC or JJ and that JC would be associated with a higher long‐term mortality and occurrence of colic. Study design Retrospective cross‐sectional study. Methods Medical records of horses undergoing celiotomy for a small intestinal obstruction and JJ , JI or JC from 2005 to 2010 were reviewed. Post operative complications were recorded. Short‐term outcome was alive vs. dead at hospital discharge and was analysed using a C hi‐squared test. Long‐term follow‐up was obtained and a Kaplan–Meier estimate of the survivor function was performed. Results There were 112 horses included. A higher proportion of JI horses had a repeat celiotomy during hospitalisation compared with horses undergoing JC . The number of horses alive at hospital discharge was not different between groups: JJ 79% (95% confidence interval [ CI ] 68–90%), JI 78% (95% CI 61–96%), JC 83% (95% CI 71–96%). Among horses discharged with long‐term follow‐up, more horses had colic after JC compared with JJ or JI . Long‐term post discharge survival based on the K aplan– M eier survivor function was lower for horses undergoing JC than JJ or JI (P = 0.04). Conclusion While there was no difference in short‐term outcome between groups, more horses with JI underwent a repeat celiotomy during hospitalisation. Horses with a JC were more likely to have long‐term complications with colic. Horses that were subjected to euthanasia because of colic within 12 months of hospital discharge either had a JC or repeat celiotomy. The results suggest that, when possible, a JI may be the preferred method of anastomosis based on more favourable survival and lower occurrence of colic long term.